Juan David Espinoza

⚡️Tips to improve lift for resection⚡️ AGA update on lifting agents: doi.org/10.1016/j.cgh.… 1. SSLs: No injection if margins are visible or < 20 mm 2. 10-30 mm lesions: central injection 3. Dominant lesions: start from accessible region 4. >30: inject, cut, repeat Agents:Fig

Leung et al. present the paper “Asian Pacific Association of Gastroenterology task force recommendations on surveillance for Helicobacter pylori associated gastric premalignant conditions” via bit.ly/4sY2YWP (Guideline section) This comprehensive guideline provides clear, practical recommendations for surveillance of gastric premalignant conditions, supporting risk-based approaches to improve early cancer detection. #GUTGuidelines #Hpylori #HelicobacterPylori

🥨 🥐 ‘But bread causes my symptoms’: possible clinical scenarios 🍞 🫚 Read this fantastic review paper by Francesca Manza and co-authors! 🍞 Wheat components can induce reactions in a number of people. ⚛️ Gluten is the known trigger in coeliac disease, mediated by human leucocyte antigen-DQ2/DQ8 and adaptive and innate immune responses. 🫚 Wheat allergy involves immunoglobulin E-mediated reactions to specific wheat proteins such as gliadins, lipid transfer proteins and albumins. WHAT THIS STUDY ADDS Non-coeliac gluten/wheat sensitivity is often overlapping with irritable bowel syndrome as it presents with shared intestinal and extraintestinal symptoms but lacks clear biomarkers, making diagnosis reliant on exclusion and food challenges. HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY Diagnosis of wheat-related disorders can be challenging in a clinical setting and requires a stepwise approach. fg.bmj.com/content/early/… @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman #wheat #gluten #coeliacdisease #celiacdisease #glutenfree #foodallergy #foodintolerance #autoimmunedisease #gastroenterology #digestivehealth #guthealth #ibd #gihealth #nutrition #malabsorption

@DouglasAdlerMD Nice case !! Did you performed sphincteroplasty ?

Two Sunday morning ERCP. One of which included a 2.5 cm stone. The fun never stops! #gitwitter

PRostate cancer guidelines 2026 update. Digital rectal exam NOW no more recommended for Asymptomatic men SO NO MORE FOR Screening Important for standing and for early diagnosis for SYMPTOMS only @Uroweb

@drkeithsiau @batuhan_MD I’m not agree, If we can do it , easily why not, I had a linfoma and a eosinofilic ulcer (pills) in a asyntomatic patient I don’t think that 60 seconds are a waste time,

🤔 Should we be doing routine terminal ileal intubation during colorectal cancer screening colonoscopy? 🔦 💡 No, according to the results of a newly published meta-analysis 👇

Paciente de 43 años con fístula biliar post quirúrgica se coloca stent plástico. El reto fue su canulación en vía larga y colocación de su stent en esa posición. WGO 🌍

For those asking, these are the probiotic strains recommended in the @WorldGastroOrg guidelines

I got asked by a fellow how to treat a patient with mild UC (never steroids) on 5ASA who developed an adverse event to 5ASA, what is the next therapy I would use. It could be argued to simply give nothing and wait, but you could also give plantago ovata and few people know about this trial from 1999 I believe, and is worth a read, @fgomollon was the one who I first heard talking about this. We often forget the power of fibers! @geteccu journals.lww.com/ajg/abstract/1…

@danatsouza @BrighamRad @FOAMrad @SAR_RFS @futureradres @ARRS_Radiology @Abdominal_Rad @CBRadiologia Most likely fnh, with a higher probability of focal nodular hyperplasia by homogeneous, regular contrast enhancement, central hyperintense scar on T2 But differential diagnosis fibrolamelar tumor

38-year-old male patient presenting with very large left lobe hepatic mass... most likely diagnosis? @BrighamRad @FOAMrad @SAR_RFS @futureradres @ARRS_Radiology @Abdominal_Rad @CBRadiologia #MedEd

Cierre de fístula biliar post quirúrgica tras manipulación quirúrgica de vía biliar. Colocación de drenaje doble para exclusión de fístula.

@Ferreira_gastro Buen caso amigo FAP.

18 años tiene . Madre Ca de colon a los 21. Poca información clínica , del área rural de Colombia.

Caso cpre: Estenos de vía biliar post quirúrgica, bismuth 2. Protocolo Stanford. Colocación prótesis bilateral para lograr drenar > 50%, de forma exitosa. Control en 3 meses y valorar estrategia. Drenaje con objetivo curativo.

Chronic #diarrhea is defined by recurrent loose or watery stools, with or without increased stool frequency, fecal urgency, or fecal incontinence, that lasts for at least 4 weeks. 📄 Learn more about diagnosis and treatment strategies in this Review: ja.ma/46vCh2T

📢 No vamos a permitir que los investigados por el magnicidio de nuestro padre intenten lavarse la cara con las declaraciones del líder de Los Lobos. ⚖️ Exigimos que se distinga entre ruido estratégico y prueba judicial, y que todos los responsables enfrenten la justicia.

@drkeithsiau Nice case, if is no contamination and good colon preparation, you can fix the problem with suture or clips, Also : - inserth a catheter in abdomen to resolve the pneumoperitoneum, - treat with broad spectrum antibiotics.

What would you do if you saw this on colonoscopy?

Read the #GUTBSGGuideline by East et al entitled "British Society of Gastroenterology guidelines on colorectal surveillance in inflammatory bowel disease" via bit.ly/4cmVRlw @drmorrisgordon @ShahidaDin1 @ProfChrisLamb @anjan_dhar6 @sdolwani @DrBuHayee @BritSocGastro #IBD

Varios casos interesantes fellow WGO IGBJ. 🇧🇴 🇯🇵 Coñangiocarcinoma bismuth 2, Mirrizzi tipo Iv. Drenaje endoscopico CPRE.

🧠🦠 Refractory disorders of gut–brain interaction (DGBI) are common, resource-intensive, and frequently challenging to manage in routine practice. When symptoms persist despite first and second-line therapies, a gastroenterologist-only model often falls short. Drawing on real-world experience from this UK neurogastroenterology centre, this review sets out a practical multidisciplinary framework integrating gastroenterology, specialist nursing, dietetics, psychology and psychiatry to deliver structured, biopsychosocial care for patients with refractory DGBI. fg.bmj.com/content/early/… @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman